April marks the end of committee hearings for 2023, only the state budget remains

Legislative update 

This week marks the end of committee hearings for 2023 now that Appropriations has concluded their final meetings. All that remains for the Legislature to complete this year is the one constitutionally required task—the state budget. Negotiations are ongoing, but rumors suggest there have been productive conversations between the legislative leadership and the Governor’s office on a compromise budget that the Republican-controlled legislature could support, and the Democratic governor could sign. We are rapidly approaching the 100-day mark (April 18), and after that, the Legislature must vote to continue doing business, as well as accept a cut to their per diem allocation. Legislative news is likely to slow in the coming weeks as those budget negotiations continue behind closed doors, but you can expect the 2024 election news to begin to ramp up—the sponsor of AzHHA’s priority bill on OTC licensure, Rep. Amish Shah, announced a run for Congress against incumbent David Schweikert this week. For AzHHA, the final outstanding bill is the aforementioned OTC licensure fix bill (HB2346). The bill was passed by the full Senate Wednesday morning, so the final step is for the bill to return to the House for a concurrence vote, and then it will go to the Governor’s desk.

As a reminder, AzHHA hosts a weekly legislative update for members every Friday to provide an in-depth assessment of Arizona legislative activity. To participate in the call, contact [email protected].

AHCCCS redeterminations have begun

On April 1, the Arizona Health Care Cost Containment System (AHCCCS) began its regular process of redeterminations for AHCCCS members. Members who no longer meet eligibility requirements or who do not respond to requests for renewals will no longer be eligible for AHCCCS. This process had been paused since the beginning of the public health emergency in January 2020. In accordance with HB2624, which was signed into law last week, AHCCCS will make redeterminations for all members by Dec. 1, 2023 who had been determined ineligible for services since Dec. 1, 2022. Since losing Medicaid is considered a Qualifying Life Event, individuals who lose coverage may enroll in other healthcare coverage options at www.healthcare.gov. AHCCCS has assembled a toolkit for providers to use in spreading the word; additional information is available at the AHCCCS Return to Regular Renewals web page.

CDC report documents disparities in mental health–related ED visits

The number of people with mental health disorders continues to rise. With this trend, racial and ethnic disparities continue to underlie who receives care for their conditions and where, according to a report by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics. The report shows that Black adults had the highest rates of mental health related emergency department (ED) visits between 2018 and 2020. Meanwhile Hispanic adults had the lowest rates and White adults fell in the middle. Black adults had longer ED wait times and longer visits than White adults and were less likely to be admitted or transferred to another hospital than Hispanic or White adults. In addition, Medicaid covered a greater proportion of visits by Black and Hispanic adults than by White adults.

Razor-thin hospital margins become the new normal

According to Kaufman Hall’s latest study, hospital finances are starting to stabilize as razor-thin margins become the new normal. Based on data from more than 900 hospitals, the study shows external economic factors including labor shortages, higher material expenses and patients increasingly seeking care outside of inpatient settings are affecting hospital finances. Hospitals' median year-to-date operating margin was -1.1% in February, down from -0.8% in January. Despite the slight dip, February marked the eighth month in which the variation in month-to-month margins decreased relative to the last three years.

April 30 DAP deadline for hospitals with an emergency department

Hospitals with an emergency department are eligible for a 0.5% Naloxone Distribution Program Differential Adjusted Payment (DAP) in Contract Year ending 2024 (10/1/23-9/30/24). Hospitals that participate will receive an additional 0.5% increase on all AHCCCS inpatient and outpatient payments during that time. To qualify, hospitals need to submit a Letter of Intent (LOI) to [email protected] no later than April 30, develop and submit a facility policy that meets AHCCCS and the Arizona Department of Health Services’ standards, and begin distribution of Naloxone to individuals at risk of overdose no later than Jan. 1, 2024. AzHHA has developed a template LOI which may be found here. AHCCCS is still working on finalizing the standards for this program and taking feedback on proposed standards through April 14. For questions, please contact Amy Upston, Director of Financial Policy and Reimbursement at [email protected].

New endorsed vendor service: Peer Review 

AzHHA is excited to welcome our newest Affiliated Partner and endorsed vendor, Washington Hospital Services (WHS), a subsidiary of the Washington State Hospital Association. WHS offers an external peer review service to AzHHA member hospitals which provides a systematic evaluation of quality and appropriateness of patient care and diagnosis, occurring on-site or remotely and across a variety of service lines. This service, which was originally designed around helping critical access hospitals meet CMS conditions of participation, is also available to larger organizations looking to free up staff time and resources. For more information, contact Laura Dickscheid, Vice President of Member Services at AzHHA, [email protected].

UPCOMING EVENTS

April 12 – Workplace violence prevention plan informational webinar

Last year, the Arizona Legislature passed SB1311 known as the Workplace Violence Prevention bill. The legislation requires that by July 1, 2023, licensed healthcare institutions with more than 50 employees must develop, implement and maintain a written workplace violence prevention plan. To assist AzHHA members in meeting requirements, a webinar on plan development and implementation will be presented by attorney Joe Clees on Wednesday, April 12 from 3 - 4 p.m. To receive the Zoom link, please register here. In addition, AzHHA is working with employment law firm Ogletree, Deakins, Nash, Smoak & Stewart, P.C. to develop a legally compliant sample plan that can be adapted to meet the needs of individual facilities.

April 19 – Compassion Fatigue workshop series

Televeda, an organization which helps improve population health, along with ADHS is providing a free workshop series about compassion fatigue. Compassion fatigue is a natural offspring of the world we have been working and living in. In the last couple of years, we have witnessed a dramatic rise in stress-related diseases, loneliness and depression, drug overdose, racial injustice, economic pressures, violence to self and others, and a seemingly unending list of other signs of disruption. This four-part series will address the adverse impacts of compassion fatigue on our health and well-being and help us navigate tailored ways to reach our own individualized sense of holistic well-being amidst challenging times.

• April 19: When Things Fall Apart: 10 a.m. – 11 a.m.
• April 26: Protecting Our Own Well-Being: 10 a.m. – 11 a.m.
• May 3: Mindfulness: “Beyond the Buzz!” 10 a.m. – 11 a.m.
• May 10: Creating a Personal Action Plan: 10 a.m. – 11 a.m.

Register for the first part of the workshop series here.

April 20 – AHA Vitality Index webinar

The webinar will provide an overview of the American Hospital Association (AHA) Vitality Index which integrates raw claims and remit information from hospitals. Using this information, hospitals can see how they are doing against their peers, but perhaps even more importantly, how insurance providers are doing against their peers. Using this data, the AHA Vitality Index can help answer questions such as: Which payers have prompt payment issues? Which hospitals have denial issues across the state? Are there specific claim types experiencing more denials or downgrades? Utilizing the AHA Vitality Index will help hospitals glean incredible insights into claims and remit issues. If you’re interested in joining contact Amy Upston, Director of Financial Policy and Reimbursement for AzHHA at [email protected].

May & June – Critical Incident Stress Management Peer Team Training for Crisis Intervention

As crises in the workplace and community disasters are becoming more frequent, the need for effective psychological crisis response capabilities becomes obvious. As a result, AzCHER will be offering Group and Individual Critical Incident Stress Management (CISM) Peer Team Training for Crisis Intervention in May and June, in the Tucson area. CISM represents a powerful, yet cost- effective approach to deal with the resultant psychological, emotional and spiritual effects from a crisis. This training will help your facility create and maintain a CISM Peer Team for both Individual and Group debriefing. Lunch will not be provided, so please plan accordingly.

Pima County Health Department Toole Warehouse: 350 S. Toole Ave, Tucson, Arizona, 85701

• May 16 & 17, 7:30 a.m. - 5 p.m. – capacity for 25 people

Abrams Public Health Center: 3950 S. Country Club Rd, Tucson, Arizona, 85714

• May 30-31, 7:30 a.m. - 5 p.m. - capacity for 25 people
• June 13-14, 7:30 a.m. - 5 p.m. - capacity for 25 people

To register, contact Cheryl Hewlett at [email protected].

AzHHA monthly workshops: Introduction to POLST

Join physician orders for life-sustaining treatment paradigm (POLST) for their one-hour virtual workshops equipping healthcare professionals with knowledge and resources to begin using POLST in Arizona. The objectives are to describe what POLST is at the state and national level, explain why POLST is important, define the population for POLST, when to begin the conversation and who completes POLST, describe the process for completing, reviewing and updating POLST, and learn the process of submitting healthcare planning documents to the Arizona Healthcare Directive Registry. Upcoming workshop dates include: 

• May 9: 2 p.m. Register here
• June 8: 10 a.m. Register here
• July 6: 10 a.m. Register here

ADDITIONAL EVENTS

April 13: AHA’s Examining Best Practices for Equitable Maternal Care

April 14: AzAHQ 2023 Spring Conference: Reconnecting on the Journey to High Reliability: This activity/program is approved by NAHQ® for 6.25 CPHQ CE credits.

April 19: AzHHA members only: Join careLearning’s webinar on the new learning management system. For more information or to receive registration information, contact Laura Dickscheid, Vice President of Member Services at AzHHA, [email protected].

April 23-25: AHA Annual Membership Meeting

May 5: March of Dimes Beyond Labels: Reducing Stigma Related To Maternal Mental Health & Substance Disorders

In the News

Maricopa Community Colleges are making a dent in Arizona's nursing shortage (AZCentral.com)

FDA approves over-the-counter Narcan. Here’s what it means (Associated Press)

U.S. judge rules insurers don’t have to cover many free preventive health services (Tucson Sentinel)